Anxiety, insomnia, depression Flashcards
Anxiety disorder symptoms
Apprehension
Worry, fear
Palpitations
Shortness of breath
Heartburn
Dry mouth
Excess sweating
What can high levels of anxiety or a “panic attack” often be misconstructed as?
as a heart attack
In order to confirm anxiety, what should the nurse do?
rule out MI first, (diagnostic tests and ECG), then obtain hx of recent events that might trigger anxiety or that might indicate drug abuse.
what information is crucial for the nurse to obtain in order to accuratley dx anxiety disorders?
- medications that may worsen/cause anxiety symptoms.
- medical conditions that may be associated with anxiety.
- consider non pharmacological interventions that will reduce environmental, physical and emotional stressors prior to rx intervention.
family ending name of benzodiazepines
“azepam”
what things should the nurse be cautious with in regards to benzodiazepines
-change dose gradually (do not stop abruptly).
-watch for suicidal ideation.
-may cause mania or psychosis.
-watch in use with dysfunctional kidneys, liver, CV or pulmonary system.
-Use cautiously when using with elderly.
what should the nurse consider when administering a patient lorazepam?
-aspirate prior to injection (IM).
-assess for paradoxial CNS excitement.
-advise pt to stop smoking.
-watch CBC, liver function and renal function.
-does pt need antianxiety drugs?
-assess for S+S of overdose or abuse.
-teach nonpharmacological methods of sleep and relaxation.
-asses for suicidal ideation
Phenobarbital serious adverse effects
-coma.
-SJS.
-angioedema.
-periorbital edema.
-throbophlebitis.
Phenobarbital adverse effects
-oversedation
-“hangover” effect/lethargy.
-hallunications.
-blood dyscrasias.
-hypocalcemia
-hepatic disease
-N/V/D/C
-paradoxical excitation in children or older adults.
how often should a patient being given IV barbs be assessed?
q 15 minutes.
prior to injection of barbs watch should the nurse do?
aspirate
When should the nurse decide to hold phenobarbital and call MD?
if the patient develops fever, angioedema, body rash.
What things should the nurse consider when a patient it taking phenobarbital
-monitor for resp depression.
-monitor for signs or blood dyscrasias.
-monitor therapeutic serum concentration of drugs such as dig, dilantin and lithium.
-teach non-pharm techs of sleep and relaxation.
-assess baseline hepatic and renal function during therapy
causes of depression
Environmental
Situational
Hereditary
What is depression no longer thought to be caused by?
parenting or unresolved childhood conflict
depression often coexists with other conditions such as
-anxiety disorders.
-substance abuse.
-HTN or arthritis
how do you define a mood disorder and what are the two types?
- A persistent disturbance in emotion that impairs ability to effectively deal with ADLs.
- depression and bipolar disorder.
Majority of persons who a).. have been diagnosed with b)..
a)..commit suicide
b).. major depression.
how many weeks are required before patients mood begins to improve on antidepressant therapy?
three or more weeks
how long does it take antidepressant therapy to reach maximal benefit.
6-8 weeks
when is the risk of suicide the highest for people with depression?
the month before pharmacotherapy
What are the nurses role in the assessment of depression
-careful monitoring of talk of sucide.
-weekly or daily patient contact.
-careful monitoring of medications.
how long can it take to see effect and optimal benefits of tricyclin antidepressants?
3 weeks to see effect.
6 weeks to see optimum benefits.
side effects of tricyclic antidepressants
- Anticholinergic effects/Sympathomimetic effects
- Orthostatic hypotension
- Sedation (Worsened by concurrent use of other CNS depressants)
- Relatively high incidence of sexual dysfunction (cause of cessation)
